Squamous cell carcinoma (SCC) of the nail unit is the most common type of nail malignancy. SCC of the nail unit is often slow-growing and may originate from the progression of Bowen’s Disease, defined as SCC in situ [1]. It is estimated that there is a 3–5% risk of Bowen’s Disease developing into invasive SCC [2]. In many cases, patients ultimately diagnosed with nail unit SCCs report that their nails had been abnormal for several years, possibly even decades. Known as the “great mimicker,” nail unit SCC has many different clinical presentations that resemble both benign and malignant lesions, and therefore diagnosis is often delayed [3, 4].